Athanasius D. George, M.D., LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D0056274 Issued in MD

Legal business name

ATHANASIUS D. GEORGE, M.D., LLC

Practice address

19735 Germantown Rd
Suite 240
Germantown, MD 20874-1214

Phone

(301) 916-4500

Fax

(301) 916-6131

NPI assigned

Oct 25, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

ATHANASIUS D. GEORGE, M.D., LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Athanasius Demosthenes George, M.D.NPI 1891823266

Title

Owner/ Sole Member

Phone

(301) 916-4500

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Part of

Athanasius D George MD LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Athanasius Demosthenes George, M.D.

  • Ophthalmology Physician
  • Germantown, MD
  • NPI 1891823266

  DC

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1962681098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19735 GERMANTOWN RD",
            "address_2": "SUITE 240",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741214",
            "telephone_number": "301-916-4500",
            "fax_number": "301-916-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19735 GERMANTOWN RD",
            "address_2": "SUITE 240",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741214",
            "telephone_number": "301-916-4500",
            "fax_number": "301-916-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHANASIUS D. GEORGE, M.D., LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHANASIUS D. GEORGE, M.D., LLC",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "ATHANASIUS",
        "authorized_official_middle_name": "DEMOSTHENES",
        "authorized_official_title_or_position": "OWNER/ SOLE MEMBER",
        "authorized_official_telephone_number": "301-916-4500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0056274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0801568",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "61704301",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "F911-0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI MD IPA OPT CHOICE",
            "identifier": "483373",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Germantown, MD
• Providers in Germantown, MD by specialty
• Ophthalmology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.